Capital Area Council of Governments

1. *Name:
2. Phone:
3. Email:

All of the information you give is confidential and will only be used to pursue an investigation of the dumpsite you have reported. However, if you do not provide your contact information an officer cannot contact you for more information to proceed with a full investigation and/or to notify you of the status of your compliant.

1. County:
2. City:
3. *Street Address or nearest roadway intersection, or estimate of block number: please be specific as possible. (For example: At the intersection of Main St and Elm):
4. *Distance from Nearest Street:
5. Description of Dumped Materials: Choose One...Household TrashConstruction or DemolitionTiresFurnitureOther
6. *Additional Information. Please provide any additional information that you feel is necessary about the location, or description of the dumpsite:

If you saw someone, or know the person who illegally dumped the materials, please provide the following information.

1. Name or Description of Person:
2. Date that Dumping Occurred: (mm/dd/yyyy)
3. Time that Dumping Occurred: (12:34 pm)
4. Type of Vehicle:
5. Color of Vehicle:
6. Vehicle License Plate:
7. Additional Information: please provide any additional information that you feel is necessary about the description of the Dumper. (i.e., Company Logo, distinguishing features, etc.):